How New Technologies Can Give the Results of a Cosmetic Procedure Without the Surgery

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New technology targets a notoriously treacherous foe: your waistline (and butt, and arms).

For those in pursuit of the least amount of body fat possible, even an optimized diet and targeted personal training can’t always cut it when it comes to those last few stubborn pounds. Now, thanks in large part to the wild success of fat-freezing innovator CoolSculpting, which was acquired by pharmaceutical giant Allergan in 2017 for nearly $2.5 billion, a slew of new technologies promise to eradicate fat and build muscle without surgery or even much sweat. An arms race is under way to develop new and improved weapons to fight the battle of the bulge.

The latest to enter the fray, Emsculpt, doesn’t remove fat in a significant way, but uses highly focused electromagnetic energy to build abdominal or gluteal muscle. According to its developer, BTL, a 30-minute Emsculpt treatment on your abs is the equivalent of 20,000 crunches. It’s not a wholly new technology: Gyms in New York City and Los Angeles use electrode-equipped suits to enhance workouts, and physical therapists have been using electric “stim” to heal injuries and help prevent muscle atrophy for years. But Jeannel Astarita, whose discreet “body and beauty lab,” Just Ageless, is tucked away on the fourth floor of New York’s 11 Howard hotel, calls Emsculpt a “game changer.”

In March, BTL announced it would be rolling out an “applicator” attachment to the Emsculpt that specifically targets arms, thighs, and calves, areas that are of particular concern to Dr. Grant Stevens’s patients. Stevens, the president and medical director of Marina Medical Center in Marina del Rey, California (and past president of the American Society for Aesthetic Plastic Surgeons), opened a clubby treatment center called Marina Manland in 2014 after realizing that half of his sculpting patients were men who, among other complaints, wanted to lose their love handles, turkey necks, and “man boobs.”

While bodywork (sans the work part) may be all the rage, the best aestheticians in the game know they can’t rest on just one treatment. Tribeca Wellness Collective, a newly expanded concierge beauty and wellness practice in Lower Manhattan co-founded by Lauren Abramowitz, Dr. Josh Trutt, and Dr. Erica Walters, offers a holistic approach to body contouring: The $4,000 Emsculpt 360 Wellness Transformation combines four 30-minute Emsculpt sessions with sophisticated body composition testing, intramuscular B12 and lipotropic injections and IV infusions (purported to help jump-start metabolism and enhance fat loss). Optional at-home peptide injections can up the fat-burning ante, according to Abramowitz. “I was seeing such a disconnect between patients looking good, thanks to fillers, lasers, and the like, and actually feeling good,” she says. “So we developed this whole-body, super-results-driven approach.”

Combo treatments have caught on: Manhattan-based dermatologist Dr. Macrene Alexiades combines CoolSculpting with minimally invasive Profound needle-delivered radio frequency for cellulite reduction and Lumenis Pollogen Legend Pro, a buzzy new device that uses TriPollar radio frequency for skin tightening. The London-based dermatologist Dr. Rita Rakus recently treated her own upper arms with a combination of CoolSculpting, UltraCel (which combines ultrasound, radio frequency, and microneedling to help lift and tighten tissue), and Unison (a so-called miracle treatment for cellulite). “Surgeons used to pooh-pooh the body machines,” says Rakus, “but not anymore.” However, she cautions, machines are for fine-tuning, not losing half your body weight.

Some people require much finer tuning than others. Facialist Teresa Tarmey, who works in New York City and London, uses the Ballancer Pro to get her A-list clients ready for red carpets and runways. A sleeping-bag-like suit that compresses and massages you from the feet to the abdomen, the Ballancer claims to promote lymphatic drainage and ease fluid retention and bloating. Tarmey used it on several Angels at a recent Victoria’s Secret show to enthusiastic reviews. “They loved it,” she says.

According to New York dermatologist Dr. Paul Jarrod Frank, regardless of who is being artfully chiseled, it’s important to manage expectations. Machines like CoolSculpting, Emsculpt, and Unison work best on people who are already close to their ideal weight and take care of themselves. “There’s no magic,” he says. “If someone needs to look like they’ve lost ten pounds in their belly, I’m going to opt for a slightly more invasive technique like laser liposuction. If they just need to lose an annoying little pinch, two or three pounds, I’m doing CoolSculpting or SculpSure, a laser that helps melt fat, followed a month later by Emsculpt.” He says that 50 percent of his practice is now body-related. “I treat areas resistant to diet and exercise, not people resistant to diet and exercise.”